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© 2004 Current Medicine Group Ltd FISIOLOGÍA DIGESTIVA (BCM II) Clase 7: Gastritis y H. pylori Dr. Michel Baró A.

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Presentation on theme: "© 2004 Current Medicine Group Ltd FISIOLOGÍA DIGESTIVA (BCM II) Clase 7: Gastritis y H. pylori Dr. Michel Baró A."— Presentation transcript:

1 © 2004 Current Medicine Group Ltd FISIOLOGÍA DIGESTIVA (BCM II) Clase 7: Gastritis y H. pylori Dr. Michel Baró A.

2 © 2004 Current Medicine Group Ltd Gastritis: overview of anatomy and histology

3 © 2004 Current Medicine Group Ltd Normal fundic mucosa

4 © 2004 Current Medicine Group Ltd General classification of gastritis

5 © 2004 Current Medicine Group Ltd Endoscopic erosive gastritis

6 © 2004 Current Medicine Group Ltd Erosive gastritis

7 © 2004 Current Medicine Group Ltd Gastritis: anti inflamatorios no esteroidales y aspirina (“Gastropatía”)

8 © 2004 Current Medicine Group Ltd Acute erosive hemorrhagic gastritis

9 © 2004 Current Medicine Group Ltd Endoscopic gastritis: alcohol Gastropatía hemorrágica alcohólica

10 © 2004 Current Medicine Group Ltd Alcoholic hemorrhagic gastritis: histologic features Epitelio intacto Bandas Hemorrágicas interglandulares Edema Ausencia de Infiltrado inflmatorio

11 © 2004 Current Medicine Group Ltd Chronic gastritis: nonspecific gastritis (a) TABLE A. CHRONIC GASTRITIS: NONSPECIFIC GASTRITIS - HELICOBACTER PYLORI

12 © 2004 Current Medicine Group Ltd Chronic gastritis: nonspecific gastritis (b)

13 © 2004 Current Medicine Group Ltd Nonerosive nonspecific gastritis: activity (a) Gastritis crónica superficial, activa (infiltrado neutrófilos y mononucleares)

14 © 2004 Current Medicine Group Ltd Nonerosive nonspecific gastritis: activity (b) Gastritis crónica superficial (infiltrado sólo mononucleares)

15 © 2004 Current Medicine Group Ltd Foveolar hyperplasia

16 © 2004 Current Medicine Group Ltd Intestinal metaplasia

17 © 2004 Current Medicine Group Ltd Endocrine consequences of chronic atrophic gastritis

18 © 2004 Current Medicine Group Ltd Enterochromaffin-like cell hyperplasia

19 © 2004 Current Medicine Group Ltd Distributions of nonerosive, nonspecific gastritis Se asocia a la presencia de H. pylori Úlcera duodenal 90% Úlcera gástrica 50-80% Anemia perniciosa Gastritis auto-inmune

20 © 2004 Current Medicine Group Ltd Serum pepsinogens and chronic gastritis

21 © 2004 Current Medicine Group Ltd Chronic gastritis: specific or distinctive gastritis

22 © 2004 Current Medicine Group Ltd Morphology and taxonomy

23 © 2004 Current Medicine Group Ltd Electron micrographs from Helicobacter pylori-infected patient (A)

24 © 2004 Current Medicine Group Ltd Electron micrographs from Helicobacter pylori-infected patient (B)

25 © 2004 Current Medicine Group Ltd Prevalence by age and country of origin (A)

26 © 2004 Current Medicine Group Ltd Prevalence by age and country of origin (B)

27 © 2004 Current Medicine Group Ltd Prevalence by ethnic group

28 © 2004 Current Medicine Group Ltd Clustering of organism within families

29 © 2004 Current Medicine Group Ltd Histologic stains (A) Warthin.Starry

30 © 2004 Current Medicine Group Ltd Histologic stains (B) Giemsa

31 © 2004 Current Medicine Group Ltd Histologic stains (C) Acridina

32 © 2004 Current Medicine Group Ltd Histologic stains (D) Gimenez

33 © 2004 Current Medicine Group Ltd Histologic stains (E) Hematoxilina-eosina

34 © 2004 Current Medicine Group Ltd Urease

35 © 2004 Current Medicine Group Ltd Urea breath tests (C13 and C14)

36 © 2004 Current Medicine Group Ltd Rapid urease tests

37 © 2004 Current Medicine Group Ltd Tests for diagnosis of Helicobacter pylori can be categorized

38 © 2004 Current Medicine Group Ltd Association of Helicobacter pylori with gastrointestinal disease

39 © 2004 Current Medicine Group Ltd Helicobacter pylori and chronic active gastritis

40 © 2004 Current Medicine Group Ltd Antral (type B) gastritis 95% porta H. pylori

41 © 2004 Current Medicine Group Ltd Helicobacter pylori's initiation of mucosal inflammation

42 © 2004 Current Medicine Group Ltd Pathway of Helicobacter pylori induction

43 © 2004 Current Medicine Group Ltd Lymphoid follicle

44 © 2004 Current Medicine Group Ltd Gastric metaplasia

45 © 2004 Current Medicine Group Ltd Histology of gastric metaplasia (A) (duodeno)

46 © 2004 Current Medicine Group Ltd Histology of gastric metaplasia (B)

47 © 2004 Current Medicine Group Ltd Helicobacter pylori and peptic ulcer disease

48 © 2004 Current Medicine Group Ltd Helicobacter pylori and peptic ulcer disease

49 © 2004 Current Medicine Group Ltd Helicobacter pylori and serum gastrin concentrations

50 © 2004 Current Medicine Group Ltd Effect of Helicobacter Pylori eradication

51 © 2004 Current Medicine Group Ltd H. Pylori y carcinoma: Epidemiology and geographic data

52 © 2004 Current Medicine Group Ltd Stored sera were analyzed for Helicobacter pylori

53 © 2004 Current Medicine Group Ltd Characteristics of gross pathology

54 © 2004 Current Medicine Group Ltd Relationship of Helicobacter pylori to gastric cancer

55 © 2004 Current Medicine Group Ltd Non-Hodgkin's lymphoma of the stomach

56 © 2004 Current Medicine Group Ltd Dense lymphoid infiltrate Hiperplasia Folicular

57 © 2004 Current Medicine Group Ltd Lymphoepithelial lesion Linfoma MALT (linfocitos B)

58 © 2004 Current Medicine Group Ltd Cytokeratin stains (A) Normal

59 © 2004 Current Medicine Group Ltd Cytokeratin stains (B) MALT lymphoma Linfoma MALT (linfocitos B)

60 © 2004 Current Medicine Group Ltd Regression of gastric mucosa-associated lymphoid tissue

61 © 2004 Current Medicine Group Ltd FIN


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